6. Types of cardiac pain Precipitated by exertion, eased by rest, characteristic distribution Coronary stenosis (rarely aortic stenosis, hypertrophic cardiomyopathy) Angina Severe, sudden onset, felt first in back, persists at rest Dissecting aneurysm Dissecting aneurysm Sharp, raw or stabbing varies with movement or breathing Pericarditis Pericarditic pain Similar sites to angina, more severe, persists at rest Coronary occlusion Myocardial infarction Characteristics Cause Type

8. Acute left heart failure Myocardial infarction Mitral valve disease Aortic stenosis Arrhythmia Cardiomyopathy Over transfusion  Left atrial pressure Pulmonary edema Hypoxia Reflex vasoconstriction Further  LV function Causes Mechanism Cardiac dyspnea

14. Descriptions of palpitation Asystole, complete heart block and ventricular tachycardia often present as syncope rather than as palpitation Heart racing or fluttering Supraventricular tachycardia Heart “jumping about” or “racing” May be unnoticed Atrial fibrillation “ Heart misses a beat “ Heart “jumps” or “flutters” Ventricular or atrial extrasystoles Patient’s description Arrhythmia